Facial transplantation: A concise update

Infante-Cossio, Pedro; Barrera-Pulido, Fernando; Gómez-Cía, Tomás; Sicilia-Castro, Domingo; García-Perla-García, Alberto; Gacto-Sánchez, Purificación; Hernández-Guisado, José-María; Lagares-Borrego, Araceli; Narros-Gimenez, Rocio; Gonzalez-Padilla, Juan-David

doi:10.4317/medoral.18552

Cited by 26 publications

(29 citation statements)

References 40 publications

(84 reference statements)

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“…Donors and recipients are matched on the basis of race, sex, blood type, human leukocyte antigen and skin color. [54,55] A full psychological evaluation before including the recipient as a candidate on a FT program is essential. [56] Evident contraindications are psychological disorders that impair the ability of the recipient to follow the immunosuppressive protocol.…”

Section: Pre-transplant Considerationsmentioning

confidence: 99%

“…To date, 4 patients with neurofibromatosis have undergone FAT. [40,51,55] However, this procedure should still be considered as an experimental option and consequently these patients as well as cancer patients must be carefully selected.…”

Section: Ft Indicationsmentioning

confidence: 99%

“…[55,70] Hyper-acute graft rejection has not been reported so far. However, most recipients had acute rejection episodes in the first year, revealed as skin redness, swelling and nodules and papules.…”

Section: Inmunologymentioning

confidence: 99%

“…Episodes of acute rejection were usually reversible with corticosteroids (bolus treatment), supplemented in some cases by topical drugs (steroids and tacrolimus). [1,55] Other treatments included the increased tacrolimus levels and topical drugs. [39,50,51,73] For monitoring rejection episodes after transplantation, clinical systematic follow up is required performing skin and/or oral mucosa biopsies.…”

Section: Inmunologymentioning

confidence: 99%

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Current role in facial allograft transplantation: what have we learned?

Infante-Cossio¹,

Barrera-Pulido²,

Gómez-Cía³

et al. 2016

PAR

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Face transplant (FT) has evolved enormously in the last 10 years since the successful completion of the first facial transplant. This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces. The authors review the literature and discuss the main surgical, immunological, and ethical aspects as well as the results described in patients undergoing FT. To date there have been more than thirty FT worldwide. The main indication was post-traumatic deformity. In all cases a standard immunosuppression was performed with three drugs, although acute rejection episodes were observed, that could be controlled with conventional immunosuppressive regimen. Overall, functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations, although long-term data are still scarce. Major complications were opportunistic infections. Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients. Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT. All these are on the basis of accurate and careful selection of wellmotivated candidates. The next challenge will be getting new immunosuppressive treatment strategies. Although clinical experience has demonstrated the FT viability, it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical, medical and ethical problems involved.

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Section: Pre-transplant Considerationsmentioning

confidence: 99%

Section: Ft Indicationsmentioning

confidence: 99%

Section: Inmunologymentioning

confidence: 99%

Section: Inmunologymentioning

confidence: 99%

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Current role in facial allograft transplantation: what have we learned?

Infante-Cossio¹,

Barrera-Pulido²,

Gómez-Cía³

et al. 2016

PAR

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“…www.tmg.org.rs Slika 2. a) Alotransplantat lica sa donora za parcijalnu transplantaciju [6]; b) shematski prikaz facijalnog flapa za kompletnu transplantaciju lica [7].…”

Section: Ciljunclassified

Face transplantation: Surgery and art 2 in 1

Davidović¹,

Veselinov²

2015

Tim Med Glas

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OPŠTA BOLNICA KIKINDA Sažetak:Uvod: Transplantacija lica je hirurški postupak presađivanja dela ili celog lica. Postupak je kompleksan i indikovan je kod pacijenata kod kojih standardne rekonstruktivne operacije ne daju efekte. Profesor Peter Butler je prvi predložio ovu proceduru 2002. godine. Cilj: Pokazati da transplantacija lica predstavlja humano primenjenu umetnost. Pacijenti i metode: U periodu od novembra 2005. do januara 2014. godine izvedeno je ukupno 30 transplantacija lica u 7 različitih zemalja. Operacije su trajale 8-36 sati i u svakoj je učestvovalo do 30 hirurga različitih specijalnosti. Pacijentima je postoperativno uvedena doživotna imunosupresivna terapija. Trajanje hospitalizacije je u proseku iznosilo 10-14 dana. Rezultati: Kompletna transplantacija lice je uspešno izvedena kod 40% (12/30), parcijalna kod 50% (15/30) pacijenata, a 10% (3/30) je preminulo usled komplikacija. Najviše transplantacija je urađeno u Francuskoj (10), potom u SAD-u i Turskoj, po 7, u Španiji 3, Belgiji, Kini i Poljskoj po 1. Prva uspešna parcijalna transplantacija lica je obavljena u Francuskoj 2005. godine ženi čije je lice unakazio njen pas, dok je prva uspešna kompletna transplantacija lica urađena u Španiji 2010. godine muškarcu koji je s desna upucao sebe u lice. Najobimnija kompletna transplantacija lica do sada urađena je 2012. godine u SAD-u, pacijentu nakon povrede vatrenim oružjem. Pored lica, pacijent je dobio novu vilicu, zube i jezik. Zaključak: Pacijent nikada neće u potpunosti izgledati kao nekada, ali neće izgledati ni kao donor, već će biti kombinacija donora i primaoca. Identitet pacijenata ostaje isti. On će i dalje imati istu gestikulaciju, isti glas i pogled... Umetnost hirurgije i jeste u tome! Ključne reči: Hirurgija, umetnost, transplantacija, lice. Summary:Introduction: Face transplantation is a surgical procedure to transplant all or part of the face. The procedure is complex and is indicated in patients when standard reconstructive surgery cannot give the desired effect. Professor Peter Butler first propounded this procedure in 2002. Objective: To show that face transplantation represents humanly applied art. Patients and methods: Between November 2005 and January 2014, 30 face transplantations were performed in 7 different countries. All operations lasted from 8 to 36 hours and were performed by 30 surgeons of different specialties. Patients were postoperatively prescribed a lifelong immunosuppressive therapy. Hospitalisation took on average 10 to 14 days. Results: Complete face transplantation was successfully performed in 40% (12/30), partial in 50% (15/30) and 10% (3/30) died because of complications. the largest number of transplantations were done in France (10), followed by 7 in USA and Turkey, 3 in Spain, 1 in Belgium, China and Poland. The first successful partial face transplantation was performed in France in 2005 on a woman whose face was disfigured by her dog. The first successful full face transplantation was done in Spain in 2010 on a man who accidentally shot himself in the...

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